Provider Demographics
NPI:1255785846
Name:OPTIMUS LLC
Entity type:Organization
Organization Name:OPTIMUS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:937-454-1900
Mailing Address - Street 1:4623 WESLEY AVE STE B
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2243
Mailing Address - Country:US
Mailing Address - Phone:513-918-2320
Mailing Address - Fax:513-918-2324
Practice Address - Street 1:4623 WESLEY AVE STE B
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2243
Practice Address - Country:US
Practice Address - Phone:513-918-2320
Practice Address - Fax:513-918-2324
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMUS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.004254225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty